Monthly Archives: June 2015

Yesterday was one of the warmest days of the year so far, and also the second student advisory panel meeting. This time it was held in Guy’s Hospital, in London Bridge. I’ll be frank – I’ve never actually been into a hospital before, and the clinical hustle and bustle of Guy’s was totally new to me, and incredibly exciting. There were eighteen members of the panel at this meeting, as well as two teachers, and, of course, Mr Lunt and Dr MacBean. We all piled into the lift, and – on a boiling June afternoon – having twenty two people in a lift that held fifteen was sweltering.

We emerged, gasping, into a blissfully cool foyer. The meeting itself was really interesting – we had talks from Dr Rafferty, a Senior Lecturer at King’s College London, and Dr Howard, a junior Doctor at King’s College Hospital. They both gave a talk about their education, how they got their jobs and what they entail, and what they enjoy about their careers in science. Dr Rafferty regaled us with stories about his time as a helicopter Houdini – he worked for the Defence Research Agency, figuring out ways to escape from helicopters that have sunk and developing breathing equipment. As someone who has an irrational fear of being stranded in the ocean, escaping from a submerged helicopter sounds horrific. But Dr Rafferty made it sound quite the adventure.

Dr Howard put me off ever being a medical doctor – she’s just finishing her second year of training and, after having a year off to have a baby (cue “ahhhhs” from the panel) she has to do seven years more. SEVEN YEARS. Now, that’s dedication. But her talk was also interesting – she told us how everyone wants an academic training programme (which is one that has time for research) and about the things that junior doctors study in hospitals – such as general surgery and trauma, paediatrics and neonatal intensive care.

After a short break wherein we had the chance to ask any additional questions to Drs Howard and Rafferty, we commenced the second part of our meeting. It was a discussion about research into post-ICU syndrome, and whether rehabilitation was the right way to get patients up and about again. Often, patients lose muscle strength after being in intensive care for a long time, because they haven’t been moving around, or because they aren’t getting enough energy, so their body starts to attack the muscles to try to get some. There are also psychological issues, cognitive problems, and problems for families who find it hard to care for a patient, after they have been discharged.

Our discussion centred on research about whether rehab was the best way to treat these patients. There are many things to consider, such as different rates of recovery, different types of treatments for different critical illnesses, and how we can even conduct clinical trials to measure the effectiveness of rehab, given that it’s hard to monitor people before they have a critical illness, because it’s often very sudden. It was all very enlightening, and gave me an insight into how hard medical research can be.

Overall, the meeting was hugely thought-provoking – I hope not just for me, but for my fellow panel members. I learnt a lot about a range of things, none of which I will forget soon. But, despite the enjoyableness of the meeting, I am very glad I won’t have to get in that lift again!

Dr Ged Rafferty is head of the King’s Muscle Lab. Here, he tells us a bit about his career and his work.

Did you always want to be a scientist?
To be honest, I would have liked to have a been a professional cyclist, but unfortunately, my shameful lack of athletic ability put paid to that. It is my love of cycling that really sparked my interest in human physiology, although I had always enjoyed biology at school.

What made you decide to go into research?
I studied Physiology at the University of Leeds, because at the time, it still had a large component of human physiology in its final year undergraduate programme. This included a week long trip to undertake cold water immersion experiments at the Institute of Naval Medicine in Portsmouth with Dr Mike Tipton, now Professor at University of Portsmouth. This, alongside my research project on muscle composition in the leg, really captured my interest and led me to undertake a PhD. I did my PhD at King’s College London, looking at control of breathing. After that, I worked for a short time at the Ministry of Defence and then became a lecturer back at King’s – I’ve been here ever since!

What do you like most about doing research?
It is very clichéd, but learning new things! I really get a kick out of expanding my knowledge and satisfying my desire to understand how things work.

What’s the hardest thing about your job?
As a Senior Lecturer at King’s College London I am expected to undertake research, teaching as well as having administrative/management responsibilities. While teaching is quite time consuming, not just requiring the time spent in direct contact with undergraduate and postgraduate students, it is not without reward, especially when you feel you have connected with the students and they have that “light bulb” moment of understanding a topic. While it is research that I get most enjoyment and satisfaction from, one of the hardest aspects is the continual pressure to obtain grant funding to support my research, both in terms of the equipment and materials required by specific research projects but also for the salaries of staff involved. Obtaining funding from grant awarding bodies such as UK research councils and charities is highly competitive and most applications are not successful, which considering the time effort that goes into preparing an application can be very disappointing.

What is the most satisfying thing about your job?
There are many, but I suppose the culmination of a period of study resulting in a postgraduate student obtaining their PhD is incredibly rewarding.

What one piece of advice would you give to people thinking about a career in science and/or research?
You need to be enthusiastic about the topic you are researching. Without the drive that comes with being interested in a field of research it is very difficult to achieve the desired outcome. Research can be incredibly exciting when studies are going well and interesting data are coming through. Unfortunately there are many occasions when experiments just don’t work or the data are not clear or studies become monotonous and repetitive. Having the enthusiasm and interest in the topic is what carries you through.

After our first Student Advisory Panel meeting, we mentioned that we were going to develop a logo for the blog and our Facebook and Twitter. A brilliant guy called Lee Taniwha has designed these for us. Lee spent a bit of time a few years ago on the receiving end of Vicky’s physio talents (he might have called it bullying at the time – physios make people work pretty hard). He’s now a graphic designer (https://www.behance.net/taniwhazdname) and has kindly donated his time and fantastic skills to help us out by designing this selection of logos.

We now need you to vote for your favourite! Either leave a comment on here saying which number (1-5) you like best, or go onto Facebook and like the one you think is the best. We will collect all of the votes from here, Facebook, Twitter and from asking around the less technically-literate people in the lab, and we will announce the winner at our next Student Advisory Panel meeting on 25th June. The winning logo will be used at the top of the blog and as our banner photo on Facebook and Twitter.

Caroline spotted a new research article today that has just been published. The study has been done by a group of scientists in Australia (and that’s not the reason it’s upside-down) who work on a very similar area of research to us, looking at how the breathing muscles work and how they respond to different situations. One of the research team actually spent some time in our lab many years ago, so we know them quite well.

Normally, all of the breathing muscles (the main ones being the diaphragm, the muscles between the ribs and some small muscles in the neck) work together to make air move into the lungs. If breathing becomes more difficult (like when people have lung disease), or if your body needs more oxygen (for example during exercise), the brain “drives” the muscles harder by sending more electrical signals down the nerves to those muscles and making them work harder. What we don’t really know is whether the brain is able to decide to send different messages to the different breathing muscles at different times.

In this study, the researchers measured how much air was moving in and out of the lungs, how much the chest and tummy were moving with each breath, how much “drive” was going to the muscles (by measuring the electrical signals going to them), and how much pressure the diaphragm was making with each breath. The measurements were very similar to the ones you can see in two of our videos, including the mouthpieces and the tubes going up the nose and down into the stomach. They made these measurements with the person standing up, lying flat on a bed, and then hanging upside down!

So, we would probably think it would be much harder to breathe when hanging upside down, because your all of your intestines would be pushing up against your lungs, so breathing would almost be like weightlifting. The researchers did find that the pressure that the diaphragm muscle had to generate for each breath was increased (to push those intestines upwards). You’d imagine then that the brain would have to send much more “drive” to the muscles. But no – the researchers found that exactly the same amount of “drive” was going to the diaphragm, and in fact slightly less to the neck muscles than when the people were standing up, even though the people were moving the same amount of air in and out of their lungs with each breath and the diaphragm was doing more work.

So how does this make sense? Well, we know that the diaphragm muscle is in fact stronger when it’s pushed up further into the chest, so actually being upside down makes the diaphragm more efficient. This is why, for the same electrical “drive”, it was able to create more pressure. We have shown this in previous studies in our lab some years ago, and we actually repeat these experiments each year for a group of students. We do breathing muscle strength tests with relaxed lungs (at the end of a normal breath out), then again with completely full lungs (which makes the diaphragm flatten down), and then again after breathing all the way out (meaning the diaphragm is higher up in the chest and more ‘domed’). We see that the best results come from the ‘breathing out’ position, then the relaxed position, and then the lowest strength values from the ‘deep breath’ position.

What’s also interesting about the results of this new study is that it seems the brain is able to work out how efficient the different breathing muscles are at any given time, and then work out where it needs to send its “drive” to. This suggests to us that there might not just be one area of the brain that sends out all the breathing messages, but that it’s a more complicated process than we thought involving a lot more feedback loops. This might be very relevant to many of our studies, so we will be reading this article closely and the findings may well be really useful to us.

But – really and truly – the best thing about this study is that they tipped people upside down! Science really can be fun (though possibly not for the people being dangled over the end of a bed with tubes up their noses…).